AB0452 AGE RELATED DIFFERENCES IN NEUROPSYCHIATRIC MANIFESTATIONS AMONG SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS – A SINGLE RHEUMATOLOGY CENTRE EXPERIENCE IN MALAYSIA
Authors: C. R. Ng
Journal: Annals of the Rheumatic Diseases (2022)

Background The prevalence of SLE in Malaysia was reported as 43/100,000 individuals and Chinese (57/100,000) have the highest prevalence followed by Malays (33/100,000) and Indians (14/100,000) [1,2]. The American College of Rheumatology established case definitions and categorised neuropsychiatric syndromes into two groups: central and peripheral system involvement. There were studies showed that cognitive impairment is the commonest neuropsychiatric manifestations with a prevalence of 66% [3]. Objectives To determine the association between neuropsychiatric manifestation with different age group among SLE patients. Methods This was a retrospective study. The electronic medical records of all SLE patients seen in rheumatology clinic of Hospital Sultan Ismail, Malaysia from 1/1/2007 to 31/12/2021 were reviewed. SLE patients with neuropsychiatric manifestations were selected and categorised by age into children (&lt; 12 years old), adolescents (aged 12-18 years), young adults (aged &gt;18 to 35 years), middle-aged adults (&gt;35 -55 years) and elderly (&gt;55 years). The association between neuropsychiatric manifestation with different age group was analysed by using SPSS-Fisher’s exact test. Results There was a total of 86 patients and female were 77. The majority were Malay (49/86) followed by the Chinese (33/86), Indians (2/86) and others (2/86). Patients were categorized into children (n:6), adolescents (n:18), young adults (n:43), middle-aged adults (n:16) and elderly (n:3) with the mean age of 28. Our study showed the onset of neuropsychiatric manifestations occurred most during young adulthood (43/86) followed by adolescents (18/86). Seizure disorders is the commonest manifestations (36/86) followed by psychosis (17/86), poly/mononeuropathy (7/86), cognitive dysfunction (7/86), myelopathy (5/86), cranial neuropathy (4/86), mood disorders (3/86), cerebrovascular disease (3/86), movement disorders (2/86), and lastly headache and myasthenia gravis, 1 patient each. 60% of the patients had onset of neuropsychiatric manifestation during first diagnosis and another 7% developed symptoms within 1 year of diagnosis. There was no association between type of neuropsychiatric manifestation with different age group (p = 0.195). Comparison of neuropsychiatric manifestations according to age group was showed in Table 1. Table 1. Neuropsychiatric manifestations according to age group Age group (years) Central nervous system Peripheral nervous system Children &lt; 12 Seizure (4), CVD (1), Cognitive dysfunction (1) Adolescents 12-18 Seizure (9), Psychosis (5), Mood disorders (1), Cognitive dysfunction (1) PN/MN (2) Young adults &gt;18-35 Seizure (18), Psychosis (10), Cognitive dysfunction (4), movement disorders (2), myelopathy (4), CVD (2) PN/MN (2) CN (1) Middle-aged adults &gt;35-55 Seizure (4), Psychosis (2), Mood disorders (2), Cognitive dysfunction (1), Myelopathy (1), Headache (1) PN/MN (3) CN (2) Elderly &gt;55 Seizure (1) MG (1), CN (1) CVD: Cerebrovascular disease, PN/MN: Polyneuropathy/Mononeuropathy, CN: cranial neuropathy Conclusion Seizure disorders is the commonest manifestations amongst SLE patients in our study group and there was no association between neuropsychiatric manifestation with the age group. References [1]S. N. Yap, M. E. Phipps, M. Manivasagar, S. Y. Tan, and J. J. Bosco, “Fc gamma receptor IIIB-NA gene frequencies in patients with systemic lupus erythematosus and healthy individuals of Malay and Chinese ethnicity,” Immunology Letters, vol. 68, no. 2-3, pp. 295–300, 1999.View at: Publisher Site | Google Scholar [2]K. H. Chua, B. P. Kee, S. Y. Tan, and L. H. Lian, “Genetic polymorphisms of interleukin-4 third intron region in the Malaysian patients with systemic lupus erythematosus,” Journal of Medical Sciences, vol. 8, no. 4, pp. 437–442, 2008.View at: Publisher Site | Google Scholar [3]Carbotte RM, Denburg SD, Denburg JA. Prevalence of cognitive impairment in systemic lupus erythematosus. J. Nerv. Ment. Dis. 1986;174:357–364. [PubMed] [Google Scholar] Disclosure of Interests None declared